Thrombocytopenia in neonates: causes and outcomes

Thrombocytopenia is one of the most common hematological abnormalities found in neonates. The causes, treatment modalities, and outcomes of neonatal thrombocytopenia have to be evaluated for providing better care and follow-up. In this study, our aim was to assess the prevalence, causes, treatment modalities, and outcomes of thrombocytopenia in neonates. A retrospective analysis was conducted on the medical records of all neonates hospitalized at our hospital between January 2007 and December 2011 and those with thrombocytopenia were included in the study. Of the 3,515 neonates, 134 (3.8 %) had thrombocytopenia. Ninety-seven of them (72 %) were preterm. In the patients admitted to neonatal intensive care unit, the prevalence of thrombocytopenia was found as 12 %, whereas it was found as 1.2 % in neonatal service. The highest prevalence was detected in the year 2008 by 5.3 %, and the lowest prevalence was detected in the year 2011 by 2.4 %. Sepsis was the most common etiologic factor between years 2007 and 2009. Intrauterine growth restriction, metabolic disorders, drugs, and asphyxia were more common causes in the recent years. Severe thrombocytopenia was found in 26 % of neonates and 11 % of thrombocytopenic neonates had major hemorrhage. Intracranial hemorrhage ratio was 5.9 % and all of these patients were preterm. Thrombocytopenia improved in 92.5 % of patients and persisted in 3 % of patients. Death occurred in 4.5 % of neonates. This study shows that the causes of neonatal thrombocytopenia may show variations with respect to time and the prevalence, complications, and risks of thrombocytopenia may be lowered by eliminating preventable factors.